What question did this study set out to answer?

To evaluate the prognostic value and clinical significance of the anatomical location of regional wall motion abnormalities detected during exercise stress echocardiography.

September 2, 2026Journal of the American College of CardiologyOpen Access

Prognostic significance of the location of wall motion abnormalities during exercise echocardiography

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: known or suspected coronary artery disease (n=4347). Intervention: Wall motion abnormalities in the left anterior descending (LAD) coronary artery distribution vs. Wall motion abnormalities elsewhere. Primary outcome: cardiac death and nonfatal myocardial infarction (MI) (p=0.009).

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Key result

Exercise LAD wall motion abnormalities linked to ~52% higher cardiac death and MI risk vs elsewhere.

P=0.009
n=4,347

Why the study?

The effect of the location of wall motion abnormalities during stress echocardiography on prognostic outcome was unknown.

Does the location of wall motion abnormalities in the LAD distribution during exercise echocardiography predict cardiac death and nonfatal MI in patients with known or suspected coronary artery disease?

Population

4,347 patients with known or suspected CAD

Comparison

Location of wall motion abnormalities during exercise echocardiography

Design

Observational cohort study

Follow-up

Median, three years

Authors

AEAbdou ElhendyMarshfield Clinic DMDouglas W. MahoneyHeart Failure & Transplant BKBijoy K. KhandheriaCardiac Imaging

Discussion

Member takes

Overview

Wall motion abnormalities in the LAD distribution during exercise echocardiography independently predict an increased risk of cardiac death and nonfatal MI, providing prognostic value beyond resting ejection fraction and extent of ischemia.

Key Points

To evaluate the prognostic value and clinical significance of the anatomical location of regional wall motion abnormalities detected during exercise stress echocardiography.
Evaluated patients undergoing exercise echocardiography for the assessment of known or suspected coronary artery disease.
Analyzed the presence and regional distribution of stress-induced wall motion abnormalities across myocardial segments in relation to long-term adverse cardiovascular outcomes.
Demonstrated that the specific anatomical site of exercise-induced wall motion abnormalities independently correlates with adverse cardiac event rates.
Showed that incorporating regional abnormality localization enhances risk stratification and prognostic accuracy beyond global left ventricular dysfunction metrics alone.

Study Design

Type

Cohort (n=4,347)

Structured PICO

Population

4,347 patients (mean age 61 years, 48.7% female) with known or suspected coronary artery disease undergoing symptom-limited exercise echocardiography, followed for a median of 3 years.

Exposure

Wall motion abnormalities in the left anterior descending (LAD) coronary artery distribution during symptom-limited exercise echocardiography

Comparator

Wall motion abnormalities in other vascular regions during exercise echocardiography

Outcome

Composite of cardiac death and nonfatal myocardial infarction (MI)hard clinical

Main Result

Absolute Event Rate: 3.2% vs 2.1%

p-value: p=0.009

Cite This Study

Elhendy et al. (2002) conducted a cohort in known or suspected coronary artery disease (n=4,347). Wall motion abnormalities in the left anterior descending (LAD) coronary artery distribution vs. Wall motion abnormalities elsewhere was evaluated on cardiac death and nonfatal myocardial infarction (MI) (p=0.009). Exercise wall motion abnormalities in the LAD distribution were associated with higher rates of cardiac death and nonfatal MI compared to abnormalities elsewhere (3.2% vs 2.1% at 3 years; p=0.009).

synapsesocial.com/papers/6a97e9f30e613c950205a1f3 https://doi.org/10.1016/s0735-1097(02)02338-0

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September 2, 2026Journal of the American College of CardiologyOpen Access

Prognostic significance of the location of wall motion abnormalities during exercise echocardiography

View Full Paper

Ask AI

Bookmark

Key result

Exercise LAD wall motion abnormalities linked to ~52% higher cardiac death and MI risk vs elsewhere.

P=0.009
n=4,347

Why the study?

The effect of the location of wall motion abnormalities during stress echocardiography on prognostic outcome was unknown.

Population

4,347 patients with known or suspected CAD

Comparison

Location of wall motion abnormalities during exercise echocardiography

Design

Observational cohort study

Follow-up

Median, three years

Authors

AEAbdou ElhendyMarshfield Clinic DMDouglas W. MahoneyHeart Failure & Transplant BKBijoy K. KhandheriaCardiac Imaging

Discussion

Member takes

Overview

Key Points

To evaluate the prognostic value and clinical significance of the anatomical location of regional wall motion abnormalities detected during exercise stress echocardiography.
Evaluated patients undergoing exercise echocardiography for the assessment of known or suspected coronary artery disease.
Analyzed the presence and regional distribution of stress-induced wall motion abnormalities across myocardial segments in relation to long-term adverse cardiovascular outcomes.
Demonstrated that the specific anatomical site of exercise-induced wall motion abnormalities independently correlates with adverse cardiac event rates.
Showed that incorporating regional abnormality localization enhances risk stratification and prognostic accuracy beyond global left ventricular dysfunction metrics alone.

Study Design

Type

Cohort (n=4,347)

Structured PICO

Population

4,347 patients (mean age 61 years, 48.7% female) with known or suspected coronary artery disease undergoing symptom-limited exercise echocardiography, followed for a median of 3 years.

Exposure

Wall motion abnormalities in the left anterior descending (LAD) coronary artery distribution during symptom-limited exercise echocardiography

Comparator

Wall motion abnormalities in other vascular regions during exercise echocardiography

Outcome

Composite of cardiac death and nonfatal myocardial infarction (MI)hard clinical

Main Result

Absolute Event Rate: 3.2% vs 2.1%

p-value: p=0.009

Cite This Study

synapsesocial.com/papers/6a97e9f30e613c950205a1f3 https://doi.org/10.1016/s0735-1097(02)02338-0

Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

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